Trend and Economic Burden of Intravenous Narcotic Analgesic Utilization in Major Vascular Interventions in the United States

Abstract: Background The use of IV narcotic analgesics (IVNA) within the context of vascular procedures is not fully described. We sought to evaluate the burden of IVNA including narcotic analgesia related adverse drug events (NARADE), associated mortality and hospitalization cost in open and endovascular vascular procedures , and to compare it with non-narcotic analgesia (IVNNA). Methods Retrospective cross-sectional study in hospitals participating in Premier database (2009-2015). Logistic regression analysis was implemented to report the risks of NARADE and in-hospital mortality. Negative binomial regression was used to assess LOS and Generalized linear modeling was used to estimate the hospitalization cost. Results A total of 171,473 patients were identified. NARADE occurred in 6.2% of the cohort. NARADE group was similar in gender and race but was slightly older (median age71 vs 70; p Conclusions and relevance The use of opioid-based narcotics had increased the risk of NARADE, resources utilization, and NARADE-related mortality. Yet the use of non-opioid based analgesic was safe, did not increase the cost, and reduced mortality in open AA repair. This entices shifting the paradigm towards exploring non-opioid based analgesia options in order to replace or minimize opioid requirements. Conclusions and relevance The use of opioid-based narcotics had increased the risk of NARADE, resources utilization, and NARADE-related mortality. Yet the use of non-opioid based analgesic was safe, did not increase the cost, and reduced mortality in open AA repair. This entices shifting the paradigm towards exploring non-opioid based analgesia options in order to replace or minimize opioid requirements.